Metastatic breast cancer

Case contributed by Dr Bruno Di Muzio

Presentation

Previous history of breast cancer.

Patient Data

Age: 45-year-old

Thoracic and lumbar spine CT

Modality: CT

Diffusely sclerotic bones with no evidence of associated pathologic fractures or significant spinal canal or intervertebral foramina stenosis. 

Bone scans (one year apart from each other)

Modality: Nuclear medicine

Tc99m diphosphonate bone scan images one year apart from each other demonstrate the diffuse progression of the bone metastasis uptake. 

Case Discussion

This patient had a bone biopsy at the time of the first sclerotic lesion presentation, as it would be crucial for treatment options at that time. 

MICROSCOPIC DESCRIPTION: Sections show multiple fragments of bone. There is focal fibrous tissue and some degenerate cells within this fibrous tissue. No definite evidence of malignancy is seen.

DIAGNOSIS: Bone biopsy:  Occasional degenerate cells positive with Cam5.2and AE1/AE3. Features suspicious for a metastatic carcinoma. There is minimal diagnostic material available for examination. The degenerate cells show strong staining with oestrogen receptor and negative for progesterone receptor. HER 2 score 0. There is limited diagnostic material, but the features are supportive of ER+ metastatic adenocarcinoma of the breast.

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Case Information

rID: 49403
Case created: 23rd Nov 2016
Last edited: 10th Dec 2016
System: Breast
Tag: rmh
Inclusion in quiz mode: Included

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